Ann Rehabil Med.  2013 Feb;37(1):88-95. 10.5535/arm.2013.37.1.88.

Somatosensory Findings of Pusher Syndrome in Stroke Patients

• Lee JH
• Kim SB
• Lee KW
• Lee JY

• KMID: 2266655
• DOI: http://doi.org/10.5535/arm.2013.37.1.88

Abstract

OBJECTIVE
To investigate the somatosensory findings of pusher syndrome in stroke patients.
METHODS
Twelve pusher patients and twelve non-pusher patients were enrolled in this study. Inclusion criteria were unilateral stroke, sufficient cognitive abilities to understand and follow instructions, and no visual problem. Patients were evaluated for pusher syndrome using a standardized scale for contraversive pushing. Somatosensory finding was assessed by the Cumulative Somatosensory Impairment Index (CSII) and somatosensory evoked potentials (SEPs) at 1 and 14 weeks after the stroke onset. Data of SEPs with median and tibial nerve stimulation were classified into the normal, abnormal, and no response group.
RESULTS
In the baseline characteristics (sex, lesion character, and side) of both groups, significant differences were not found. The score of CSII decreased in both groups at 14 weeks (p<0.05), but there were no significant differences in the CSII scores between the two groups at 1 and 14 weeks. There were no significant differences in SEPs between the two groups at 1 and 14 weeks after the stroke onset.
CONCLUSION
It appears that somatosensory input plays a relatively minor role in pusher syndrome. Further study will be required to reveal the mechanism of pusher syndrome.

Keyword

Pusher syndrome; Stroke; Somatosensory evoked potentials; Cumulative Somatosensory Impairment Index

MeSH Terms

Evoked Potentials, Somatosensory
Humans
Stroke
Tibial Nerve

Figure

• 

  Fig. 1 The enrollment algorithm for the subjects from May 2010 to August 2011. The 24 patients included in the study were among the 131 stroke patients. PS, pusher syndrome; CSII, Cumulative Somatosensory Impairment Index; SEPs, somatosensory evoked potentials.

• 

  Fig. 2 Mean scores for the Scale for Contraversive Pushing (SCP) subscales (posture, abduction, resistance) at 1 and 14 weeks. (A) Experimental group and (B) control group. The values are expressed as mean±standard deviation.

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